米索前列醇配伍钙制剂在预防经产妇自然分娩产后出血中的应用

Application of misoprostol combined with calcium preparations in preventing postpartum hemorrhage of natural childbirth multipara

目的寻找经济有效的预防产后出血的方法。方法将自然分娩的经产妇414例随机分成两组,观察组214例于宫口开全后予以10%葡萄糖酸钙10ml+0.9%氯化钠注射液20ml静脉注射。再于胎儿前肩娩出后予以0.9%氯化钠注射液20ml+缩宫素20IU静脉注射,同时米索前列醇200μg舌下含化。对照组200例于宫口开全后予以0.9%氯化钠注射液30ml静脉注射。再于胎儿前肩娩出后予以0.9%氯化钠注射液20ml+缩宫素20IU静脉注射同时安慰剂舌下含化。分别计算产后2h出血量及第三产程时间。结果两组产妇产后2h出血量分别为156.6±98.2、228.7±134.6ml,第三产程时间分别为7.03±2.57、10.06±3.21min。结论葡萄糖酸钙,米索前列醇,缩宫素三药合用较缩宫素单独应用对于预防产后出血有较好效果,可明显预防产后出血的发生。

Objective To explore a cost-effective way to prevent postpartum hemorrhage .Methods The clinical data of 414 cases of maternal vaginal deliveries was retrospectively analyzed ,the patients were randomly divided into two groups .214 of them ,as treatment group ,were given intravenous injection of 10% calcium gluconate 10 ml and 0 .9% saline 20ml followed by intravenous injection of 0.9% saline 20 ml ,oxytocin 20 IU and misoprostol 200 μg sublingual after the fetus＇s fore shoulder were dilivered .200 cases ,as control ,were given intravenous injection of 0.9% saline 30 ml followed by intravenous injection of 0 .9% saline 20 ml ,oxytocin 20 IU and placebo after the fetus＇fore shoulder were dilivered .Postpartum hemorrhage amount in two hours and the third labor time were respectively calculated .Results The postpartum hemorrhage amount in two hours of two groups were 156.6 ± 98.2 ml vs 228.7 ± 134.6 ml ,the third labor time were 7.03 ± 2.57 min vs 10.06 ± 3.21 min .Conclu-sion Calcium ,misoprostoland and oxytocin used together had a better effect on preventing postpartum hemorrhage than oxyto-cin alone ,which could obviously prevent postpartum hemorrhage .